WHAT IS A MIDWIFE
Midwives
take care of women during pregnancy, labor, birth and the postpartum. When delivery takes place out of the hospital
setting, the midwife is also responsible for taking care of the newborn. Midwives may also provide well women
gynecology services.
MIDWIVES MODEL OF
CARE
The
Midwives Model of CareTM (http://cfmidwifery.org/mmoc/define.aspx) is based on the fact that pregnancy and birth
are normal life processes.
The Midwives Model of Care includes:
- Monitoring the physical, psychological, and social well-being of
the mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and
prenatal care, continuous hands-on assistance during labor and delivery,
and postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care
has been proven to reduce the incidence of birth injury, trauma, and cesarean
section.
TYPES OF MIDWIVES
There
are two types of midwife in the United States:
- Nurse-midwives are educated and
licensed as nurses first, and then complete additional education in
midwifery. They are known as Certified
Nurse-Midwives (CNMs). CNMs are
licensed to practice in all 50 states.
They are usually licensed in individual states as Nurse
Practitioners (NPs).
- Direct-entry midwives are
educated or trained as midwives without having to become nurses first. They may be Certified Professional
Midwives (CPMs) or Certified Midwives (CMs). The legal status and requirements for
direct-entry (non-nurse) midwives vary from state. They are usually licensed in individual
states as Licensed Midwives (LMs) or Registered Midwives (RMs). The Midwives Alliance of North America
tracks the laws and regulations in each state for direct-entry midwives (http://mana.org/laws.html).
NATIONAL MIDWIFERY
ORGANIZATIONS
Each
of the national professional organizations plays an important part in the
existence of a profession. Aspiring
midwives must first receive some kind of education and clinical training. Educational programs are able to become
accredited through a professional accreditation agency. Graduates can become nationally certified,
which may be a requirement to obtain a license to practice in a state, province
or country. Professional organizations
support practicing midwives through core competencies, standards of practice,
ethical guidelines, continuing education, research, advocacy and networking.
ACCREDITATION
Pre-accreditation and accreditation are voluntary
processes between the education program or institution and the accrediting
agency. The goal of accreditation is to provide
quality education so when students graduate they are well prepared to become
credentialed and practice their chosen profession. Accreditation assesses the quality of
education relative to the national professional core competencies and standards
of practice, student services, the financial stability of the institution, and
other student safeguards.
ACCREDITATION ORGANIZATIONS
FOR MIDWIVES
The
two organizations in the United States that provide national accreditation for
midwifery education programs are:
- The Midwifery Education
Accreditation Council (http://www.meacschools.org). Midwifery education programs accredited
by MEAC fulfill the requirements for national certification by the North
American Registry of Midwives.
- The Accreditation Commission
for Midwifery Education (http://www.midwife.org/acme.cfm). Midwifery education programs accredited
by ACME fulfill the requirements for national certification by the American Midwifery Certification Board.
The
US Department of Education recognizes select accrediting agencies as reliable
authorities regarding the quality of education or training offered by the
institutions or programs they accredit. Accreditation by a recognized accrediting
agency allows institutions to participate in federal student aid programs (http://www.ed.gov/admins/finaid/accred/index.html
). Both MEAC (Midwifery Education
Accreditation Council) and ACME (Accreditation Commission for Midwifery
Education) are recognized by the US
Department of Education. MEAC’s
website explains how students benefit from attending an accredited program (http://meacschools.org/prospective_students.php?ID=35).
CERTIFICATION
Certification
agencies are made up of consumers and experts in the profession. They
develop criteria for education, training
and clinical experience based on what
experts in the field determine is necessary for someone to practice safely as
an “entry level” practitioner. An
“entry level” midwife has completed education and training to know how to care
for healthy women with a normal pregnancy, labor and delivery, how to risk
screen for problems, when to consult, refer or transfer care, and how to handle
emergencies while getting medical help.
Certification agencies administer a written examination and in some
cases also a skills practicum examination.
CERTIFICATION ORGANIZATIONS
FOR MIDWIVES
The
two organizations in the United States that provide national certification for
midwives are:
- The North American Registry of Midwives
– NARM (http://www.narm.org)
- The American Midwifery
Certification Board – AMCB (http://www.amcbmidwife.org
)
A
Certified Professional Midwife (CPM) has earned national certification through
the North American Registry of Midwives (http://www.narm.org). Client continuity of care and clinical birth
experiences in out-of-hospital settings
(birth center or home) are required for certification. Education can be obtained through a MEAC
accredited or non-accredited school or program, or through apprenticeship. Midwifery practice guidelines, an informed
consent document, and an emergency care plan are required. Graduates of a MEAC accredited program must
pass the NARM national written certification examination. Graduates of other educational programs or
routes must complete the NARM PEP Process and pass a skills practical
examination in addition to the written examination.
A
Certified Nurse-Midwife or Certified
Midwife has earned national certification through the American Midwifery
Certification Board (http://www.amcbmidwife.org).
They must complete a graduate-level
educational program accredited by the Accreditation Commission for Midwifery
Education (http://www.midwife.org/acme.cfm)
that provides clinical birth experiences in hospitals, and pass the AMCB
national certification examination.
The
National Commission for Certifying Agencies (NCCA) was created in 1987 by the National Organization for Competency Assurance (http://www.noca.org) to ensure the health,
welfare and safety of the public through accrediting a variety of certification
program/agencies that assess professional competence. NCCA accredits over
200 programs from more than 100 organizations. NCCA accredited programs certify individuals
in a wide range of professions and occupations. Both the North American Registry of Midwives
and the American Midwifery Certification Board are recognized by the National
Commission for Certifying Agencies (NCCA). (http://www.noca.org/Resources/NCCAAccreditation/tabid/82/Default.aspx)
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